Background Weaning failure is commonly caused by diaphragmatic dysfunction, since diaphragm is the primary inspiratory muscle. Assessing diaphragmatic and lung weaning parameters using ultrasonography is noninvasive and inexpensive method. Aim This work aimed to evaluate usefulness and validity of various lung and diaphragmatic sonographic parameters as predictors of weaning outcomes of mechanically ventilated (MV) patients. Patients and methods This observational cross-sectional study included MV patients (≥18 years) in the ICU at Chest Hospital, Tanta University, on ventilation for greater than 48 h. Patients underwent history, examination, acute physiology, and chronic health evaluation II score calculation, and a spontaneous breathing trial. After 10 min, diaphragmatic and lung ultrasound were performed. Patients were divided into two groups: group I (successful weaning) and group II (failed weaning, requiring reintubation or noninvasive ventilation within 48 h). Results Group (I) involved 35 (70%) patients in whom acute physiology, and chronic health evaluation II score, rapid shallow breathing index, minute ventilation, duration of MV, length of ICU stay, mortality, and lung ultrasound score were significantly lower than in group (II) which involved 15 (30%) patients. While partial pressure of arterial oxygen to fraction of inspired oxygen ratio, diaphragmatic excursion, time to peak inspiratory amplitude (TPIAdia), diaphragmatic speed, diaphragmatic thickness (DT) at the end of inspiration and expiration, DT difference (DTD) and DT fraction were significantly higher in group (I) than in group (II). Conclusion Bedside sonographic assessment of diaphragm and lung could be used as predictors of weaning outcome in MV patients beside conventional weaning parameters.
Elkotory et al. (Wed,) studied this question.